<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".27" citation="COMAR 10.67.04.27" title_num="10" subtitle_num="67" chapter_num="04" heading="Newborn Coordinator.">
  <paragraph num="A.">
    <text>An MCO shall identify a newborn coordinator who shall be available to providers during the MCO's business hours as a contact for concerns related to eligibility and provision of services to newborns.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The newborn coordinator shall provide services for a newborn:</text>
    <paragraph num="(1)">
      <text>Whose mother is enrolled in the MCO on the date of the newborn's birth; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Who is enrolled or who is autoassigned to the MCO after birth.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The newborn coordinator shall:</text>
    <paragraph num="(1)">
      <text>Research and confirm the assignment of an eligible newborn to a managed care organization;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Interface with the enrollment agent, the Department, the newborn coordinators of other MCOs, and the provider to resolve any eligibility issues involving multiple MCOs;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Facilitate and confirm the selection of a primary care provider for an eligible newborn;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Request an MCO ID card for a newborn when necessary;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Make retroactive PCP enrollments when necessary;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Facilitate the resolution of claims for services provided to an eligible newborn;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Provide general guidance to providers and their office staff on newborn-related issues;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Coordinate with ancillary care providers to facilitate appropriate delivery of care and payment of claims; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Coordinate and authorize in-network care when the newborn does not yet appear in EVS or the MCO's system, or out-of-network care when the MCO cannot offer an appropriate in-network provider.</text>
    </paragraph>
  </paragraph>
</regulation>